As Team USA preps for the Winter Olympics festivities to kick off this weekend, it’s not only the 243 athletes who are getting ready for action — it’s also a crew of medical volunteers who undergo a grueling selection process of their own.

The official U.S. Olympic Committee’s Sports Medicine Division recruits a crew of volunteer doctors — as well as orthopedists, chiropractors, nurses, sports therapists, massage therapists, and more — every two years. Those selected will work with Olympic teams during training and practices and ultimately at the games themselves — some caring for one team exclusively; others moving around as the need arises. And they do it all uncompensated.

It’s a lot to ask from a volunteer, but former Olympic physicians say the experience is worth it. “I knew I wasn’t going to make it there as an athlete,” said Dr. Mark Hutchinson, an orthopedist in Chicago. “But I thought that as a doctor, I could go and enjoy Olympic glory vicariously.”

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Hutchinson was a volunteer physician at the 2016 Summer Olympics in Rio de Janeiro, working primarily with the equestrian and rhythmic gymnast teams.

As with any selective process, it starts with the application. Applicants must be licensed or certified, have at least three years of experience, and have no felonies, disciplinary actions, or sanctions. Doctors also must have a current Drug Enforcement Administration registration, at least $1 million in malpractice insurance, and current certification in using CPR and external defibrillators. They will also need certification in sports medicine, for which some applicants will need additional coursework before they can apply to the Olympics. With a pile of documents and a $90 application fee to cover the background check, the process begins.

If all checks out, applicants will visit a U.S. Olympic Training Center — in Chula Vista, Calif.; Colorado Springs, Colo.; or Lake Placid, N.Y. — for further training, interviews, and to care for athletes who are in training.

“You have a kind of internship type of thing, where you get to know their system, [and] they get to know you, basically,” said Dr. Scott Rodeo, a sports medicine surgeon at the Hospital for Special Surgery who volunteered with the U.S. Olympic swim team in 2004, 2008, and 2012. “Then you start with smaller competitions.”

This is where the doctors’ real tryouts happen. The USOC routinely emails applicants notices of volunteer medical rotations at national events like Olympic qualifiers or international competitions like the Pan American Games. Medical team applicants race to sign up for these rotations, which are assigned on a first-come, first-served basis. If they get an assignment, they must travel to the event location at their own expense.

“You get invited to travel with a team — like basketball or field hockey — and you just go,” said Hutchinson.

At these events, they work alongside other applicants, evaluating and treating athletes, coaches, and guests. They are on call for all emergencies. They assist at the on-site sports medicine clinic, helping athletes put on braces or tape, do stretches, or other preparations. They’re required to attend all team practices and even to help set up and take down equipment, in addition to maintaining paperwork and helping with cleaning and laundry.

And all under scrutiny.

“At any time, you can be told, ‘Thank you for your service,’ then you’re done there and sent home,” said Hutchinson. “Some people didn’t make it because they got bad comments from athletes or the coaches didn’t like them.”

“You need to be ready to work and check your ego at the door,” said Rodeo. “It’s a little bit like residency.”

And the process can be longer than most medical residencies. Doctors hoping to get to the Olympics can spend two, five, or even 15 years working events and training.

Meanwhile, the USOC further narrows down the number of applicants at various points along the way. Those selected to attend to athletes at the Olympics usually learn of their selection the year before, after a process as mysterious as it is arduous.

“You get an email saying you’ve been selected,” said Dr. Kim Tee, a Chicago podiatrist who volunteered with the U.S. golf team in Rio in 2016. “After you meet all the criteria. But the criteria, that is something only the committee knows.”

There are some shortcuts to help your case, however.

“You want to keep your name in front of the committee, but not just be in their face all the time,” said Hutchinson. “So I got around that by sending them an updated CV once in a while, with a friendly note.”

Or there are other approaches. “Sometimes you can get one of the athletes to write a letter to the committee saying that they like working with you and they want to work with you at the Olympics,”explained volunteer Dr. David Pascal, a North Carolina chiropractor.

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At the games themselves, much of what doctors deal with is “just travel medicine,” Rodeo said. “So, we’ll get a lot of stomachaches and everything that comes with eating different food or drinking different water or switching to a different time zone.”

But literally anything can happen, said Tee.

“On the 18th hole of golf, a guy from South America got too excited and fell down and ruptured a ligament in his ankle,” he recalled. “A Hong Kong swimmer fainted, another athlete got stung by a bee. And everybody was worried about Zika.”

The job can be demanding in other ways, too. It’s a significant commitment of not just money but time. “Over the time I was trying out, I was away from my practice for six months, and lost about a quarter of a million dollars,” said Hutchinson.

“You give up a lot to do it,” Rodeo said. “And it’s not just the financial issues. It’s time away from your patients.”

Among Rodeo’s patients are NFL players on the New York Giants. He said he is grateful that he can work with the Summer Olympics in the off season. “Some people can’t take that time away from their practice,” he said.

The reward is the opportunity to work long, hard days at a far-off locale.

“It’s volunteerism at its best,” said Rodeo. “You do it because you want to give back. You have to love it to do it.”

Pascal, who has gone to the Olympics five times, agreed. “The hours are long but the memories last a lifetime,” he said. “And you get some really cool USA clothes.”

This article goes beyond treating the USOC with kid gloves and seems like an active campaign to polish their image. What was the background for this article? Did these docs and quacks (I’m sorry, does STAT promote chiropractic now?!) reach out to you, or did you reach out to them?

What don’t you understand about the article, Brad? It’s the reality of the process that providers go through to be chosen as a sports medicine provider at the Olympics. You’re angry that a health-based website wrote an article about healthcare providers. Ok. What’s your beef with chiropractors too? I’m sure you’ll love to hear that the Director of Sports Medicine for the USOC is a chiropractor! Calling doctors of chiropractic quacks as a PROFESSION rather than individual providers (like there are in all healthcare fields)? Ha, get with the times, man.